The Initial Insulin Pump Requirements calculator estimates the initial insulin requirements for when you first use your insulin pump.

Before starting to use an inulin pump, patients should be instructed on how best to operate a pump by their healthcare professional.

As well as pump operatio, patients need instruction in how to insert and care for their infusion set, and how to deal with any problems.

The Insulin Pump Forum on the Diabetes Forum is a great resource for helping with this.

Usually, the insulin pump will require around 80 per cent of the insulin requirement before beginning pump therapy. 50% of the insulin is given at the basal rate, whilst the other 50% if divided into three premeal boluses.

The initial insulin dose calculator will help patients to estimate their initial insulin requirements.

Basal Rate

Fig 1: Example basal rate settings for a patient with Dawn phenomenon
Begin time Basal rate
12:00 AM 0.6 U/hour
4:00 AM 0.8 U/hour
10:00 AM 1.0 U/hour

The basal rate is adjusted following closely monitoring the blood glucose levels over a 24-hour period. To accurately calculate how much is needed, blood sugar levels are obtained before meals, one hour after meals, at bedtime, at 12.00 AM and at 3.00 AM.

The goal of adjusting the basal rate is to maintain the desired range of blood glucose levels.

The basal rate is adjusted very slightly in 0.1-0.2 U/hr increments to keep premeal and overnight blood glucose within 1.7 mmol/L (30 mg/dl) of the desired range. In some instances, basal insulin requirements will be less at certain hours of the day.

Pre-meal Boluses

Boluses will be adjusted according to postmeal blood glucose levels.

The pre-breakfast bolus will normally be ~ 8 units. Pre-lunch and pre-dinner boluses are usually lower, at around ~ 4 units.

Correction of the bolus may be required if the premeal blood sugar is too high or low.

Covering Carbohydrate with insulin

A rule known as the 450 or 500 Rule can be used to calculate the amount of insulin used to cover a particular intake of carbohydrates

Insulin/Carb ratio can be understood by using the calculation: 450/total insulin dose=grams of carbohydrate covered by 1 unit of insulin.

This calculator can help you to calculate the amount of insulin required to cover a certain amount of carbohydrate.

Correction Bolus

A premeal blood sugar reading can be alarming if it is elevated. The amount of insulin necessary to correct this level may be estimated using the 1500 rule (for regular insulin) or the 1800 rule (for Humalog).

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